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Transcatheter mitral valve replacement with a novel self-expandable prosthesis

single institutional experience procedural outcomes and follow-up

Ussia, Gian Paoloa; Cammalleri, Valeriaa; Mehta, Jawahar L.b; Sarkar, Kunalc; Muscoli, Saverioa; de Vico, Pasqualea; Ruvolo, Giovannid; Romeo, Francescoa

Journal of Cardiovascular Medicine: June 2017 - Volume 18 - Issue 6 - p 415–424
doi: 10.2459/JCM.0000000000000513
Research articles: Valve disease
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Aims We report our experience with the CardiAQ prosthetic valve using both transapical and transseptal access. Aim of our study was proving the feasibility, safety and effectiveness of a novel transcatheter mitral valve bioprosthesis.

Methods Four patients with severe mitral regurgitation, not eligible for mitral valve surgery, were treated with the CardiAQ valve. The procedures were performed under general anaesthesia, fluoroscopic and transesophageal echocardiographic guidance. We used a transapical approach in two patients and transseptal access in the others.

Results Procedural success was obtained in all patients without extracorporeal circulation support. Mean procedure time was 128 min (range 90–180) and mean hospitalization duration was 12 days (range 4–24). The transseptal approach resulted in significantly shorter in-hospital stay with quick recovery. One patient died on day 35 from septicaemia and another one died after 5 months from major bleeding. The survival patients are presently in New York Heart Association I-II with improved left ventricular ejection fraction and normal quality of life.

Conclusion CardiAQ valve placement is safe using a transapical or transseptal approach. Following valve replacement, there was a marked functional improvement in survivors. Transcatheter mitral valve replacement is a promising therapy for mitral regurgitation in a selected patient population.

aDepartment of Medicine, Università degli Studi di Roma ‘Tor Vergata’, Rome, Italy

bDepartment of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

cDebakey Cardiovascular Institute Houston Methodist Hospital, Houston, Texas, USA

dDepartment of Surgery Università degli Studi di Roma ‘Tor Vergata’, Rome, Italy

Correspondence to Gian Paolo Ussia, MD, FACC, FSCAI, Dipartimento Medicina dei Sistemi, Università degli Studi di Roma ‘Tor Vergata’, Via Montpellier, 1 - 00133 Roma, Italy E-mail: gian.paolo.ussia@uniroma2.it

Received 1 September, 2016

Revised 21 October, 2016

Accepted 22 November, 2016

© 2017 Italian Federation of Cardiology. All rights reserved.